Background Paediatric endoscopies are expensive and invasive procedures requiring general anaesthetic and should be performed to answer specific clinical questions. There is an increase in number of endoscopies performed in children but no epidemiological evidence of increasing paediatric GI disease burdens. Biopsies are also routinely performed during endoscopies adding to overall procedure cost.

Aims This study aimed to assess the indications of paediatric endoscopy, the association between endoscopic and histological results and the correlation between endoscopy and clinical outcome defined as discharge from hospital follow up.

Patients and Methods Retrospective review of clinical databases from June 2015 to July 2019. Only first diagnostic endoscopies were included, subsequent endoscopies and therapeutics endoscopies were excluded. Number of clinics prior and up to 6 months of endoscopies were reviewed and outcomes at 6 months were assessed. Correlation between endoscopy, histology results and outcome at 6 months were calculated using phi correlation

Results 196 children were included, 47.6% were females. Mean (± SD) age 10.9 (± 3.8). Indications were: abdominal pain 33%, diarrhoea 14%, rectal bleeding 9%, suspected coeliac 7.5%, constipation 9%, reflux 12.3% and vomiting 15.1%. 71.3% were upper endoscopies only and 28.7% were upper and lower endoscopies. 64% of all endoscopies were normal and 43.4% of the total were histologically normal. Number of clinics prior to endoscopies were 1.39 (±1.0) and children were seen 2.3 (±1.6) times in the six months after endoscopy. 18.5% of children were discharge from follow up within 6 months of having an endoscopy. There was weak (phi 0.18) but statistically significant (p<0.05) correlation between endoscopy and discharge at 6 months. There was also weak (phi 0.2, p 0.006) correlation between histology results and discharge at 6 months. There was a strong (phi 0.46 p<0.005) positive correlation between endoscopic appearance and histological results.

All children were day cases and there was no complication identified in the studied population.

Conclusion Paediatric endoscopy appears to be a safe procedure with low risk of complication and most children were discharge on the same day. The majority of endoscopies in children were normal and about half were histologically normal with strong positive correlation between endoscopic and histological results, hence biopsies should not be performed if endoscopy is normal. Endoscopy did not appear to influence discharge from hospital follow up and the majority of children were still under follow up 6 months after having an endoscopy.